Abstract P6-08-06: Uncovering gaps in patient-provider perceptions of triple-negative breast cancer care: Addressing disparities through education-advocacy partnerships
Authors: Tariqa Ackbarali, Ricki Fairley, Tiffany A. Traina
Journal: Cancer Research (2023)

Abstract Background: Providers and patients alike are unaware of the racial disparities that exist in triple-negative breast cancer (TNBC), which occurs at twice the rate in women of the African Diaspora (WAD) compared to White American women. WAD tend to be diagnosed at a more advanced stage, use under-resourced health care settings or encounter bias in their care, and experience higher rates of TNBC-related mortality. An historically difficult-to-treat breast cancer subtype, the TNBC landscape is changing with an influx of clinical data and newly approved treatments. An educational initiative was designed to heighten awareness of new therapies, including antibody drug conjugates, empower patients in their care, and to align on addressing disparities in TNBC care. Methods: Two, 1-hour online, interactive, video-based programs were designed for patients and providers. The patient/caregiver program was hosted on CancerCoachLive in April, 2022 and the provider program on OMedLive in May, 2022 and remains on-demand until May 2023. With a focus on addressing disparities in care, 78% of patients/caregivers attending the patient program were of African descent. The initiative was conducted in collaboration with TOUCH, the Black Breast Cancer Alliance and the National Breast Cancer Foundation. Four real-world patient accounts of TNBC navigation and management were embedded in the patient program; and represented women of Caucasian, African, and Native American ethnicity. While practice and knowledge gaps among HCPs, and knowledge gaps of patients were assessed, we report on the analysis of ‘tethered’, behavioral, practice pattern, and perception questions assessed across the patient and provider programs. Results: As of June 2022, 200 providers and 29,389 patients/caregivers participated in the ongoing activities. Post education, participants in the provider program anticipated the education would positively impact practice behavior (86%) while patients/caregivers reported greater confidence in discussions with their treatment team (92%). Pre- and post-evaluation of strategies addressing disparities revealed improvements in ‘ensuring access to care through integration of care coordinators or social worker as part of the healthcare team.’ Provider assessment of barriers to enrollment in clinical trials uncovered the top barrier as ‘lack of trials at my institution’ (33%) and the top barrier to integration of new therapies as ‘lack of knowledge regarding evidence-based strategies’ (44%). Misalignments in patient-provider perceptions were observed. ‘Patient lack of interest’ was a provider-identified barrier to clinical trials, yet 60% of patients/caregivers reported that they were ‘very likely’ to participate in a clinical trial if eligible. Similarly, differences were seen in the ranking of topics of highest interest regarding treatment decisions. Lastly, patient- vs provider-identified care challenges were not aligned. Themes from the real-world patient accounts provided greater context for the misalignments observed. Conclusions: Assessment and alignment of patient-provider care perceptions has potential to impact clinical practice behaviors, patient/caregiver communication and confidence, and treatment/clinical trial knowledge for effective TNBC management. This educational partnership facilitated assessment of attitudes, perceptions, and barriers to care that can further guide how disparities in care for patients with TNBC are addressed. This ‘tethered’ approach to education was successful in empowering patients in shared decision-making, initializing changes in clinical practice, and gaining patient-provider insights in TNBC management. This activity was supported by an educational grant from Gilead Sciences, Inc Citation Format: Tariqa Ackbarali, Ricki Fairley, Tiffany A. Traina. Uncovering gaps in patient-provider perceptions of triple-negative breast cancer care: Addressing disparities through education-advocacy partnerships [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-08-06.